Individual provider Active NPI

Karen Lynn Koskinen

  • Clinical Social Worker
  • Wildomar, CA
National Provider Identifier
1356070502
Registry record updated Jun 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
100057 Issued in CA
Practice address
32864 Celeste Way
Wildomar, CA 92595-9618
Phone
(951) 514-7497
NPI assigned
Jun 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 100057 CA Primary

Addresses

Primary practice location

32864 Celeste Way
Wildomar, CA 92595-9618

Mailing address

32864 Celeste Way
Wildomar, CA 92595-9618
Phone (951) 514-7497

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231113002275 CA Practitioner - Clinical Social Worker 8022465087 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100057CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inlandpsych Redlands Inc CurrentSince Sep 19, 2023 Accepting new patients
Inlandpsych Redlands Inc CurrentSince Sep 19, 2023 Accepting new patients

Locations

701 Highland Springs Ave
Ste 7
Beaumont, CA 92223
Phone (951) 849-7455

255 Terracina Blvd
Ste 204
Redlands, CA 92373
Phone (909) 496-1266

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654387200000",
    "number": "1356070502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32864 CELESTE WAY",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925959618",
            "telephone_number": "951-514-7497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32864 CELESTE WAY",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925959618",
            "telephone_number": "951-514-7497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSKINEN",
        "first_name": "KAREN",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-05",
        "last_updated": "2022-06-05",
        "certification_date": "2022-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "100057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wildomar, CA

Sources for this page

Verify at the official NPI Registry.